Quality improvement and patient safety in healthcare systems can be achieved only if information technology and standards of care are implemented in hospitals. Implementation of information technology has not been achieved in most rural and small community hospitals. Furthermore, the impact of mandated implementation of quality measures has not yet been felt by hospital administrators and practicing physicians, especially those in rural areas. Unless rural healthcare facilities can implement both of these innovations, they are likely to be driven out of business, leaving millions of patients without access to even acute care. The objective of this project is to implement advanced Information Technology and standards of care in rural and small community hospitals throughout the state of Texas to increase patient safety and quality of care. The Specific Aims are: (1) implement web-based business intelligence tools, internet connectivity, and standardized national measures of patient safety and quality to improve delivery of care; (2) implement advanced technology with an enriching educational Intervention to support a committed patient safety and quality culture; (3) conduct a randomized trial to evaluate the effects of technology and the incremental effects of an educational intervention on patient safety and quality. This collaboration is particularly well suited to conduct this project because the partners include the Palo Pinto General Hospital as the applicant on behalf of a network of rural facilities, the Rural and Community Health Institute of Texas A&M University System Health Science Center, the Dallas/Fort Worth Council of hospital Data Initiative, the Baylor Health Care System, and the Texas Medical Foundation. This project is significant because we expect to implement advanced Information Technology and standardized national measures of care in rural and small community hospitals and to evaluate the effectiveness of an educational intervention to accomplish this implementation. [unreadable] [unreadable]